It didn’t take long for HIV to throw a monkey wrench into the way my body handles food from one end (how well I digested and absorbed it) to the other (how well I eliminated it). What helped was combining regular exercise with good nutrition, a dynamic duo of interventions that can join forces to improve your health in important ways.

One of these ways is by reducing stress. When stressed, the body’s “fight or flight” response shuts down all systems that aren’t absolutely necessary, including digestion of food. Long-term activation of this response by emotional or physical stress can seriously decrease nutrient levels. Using exercise to reduce anxiety can help.

Exercise can also improve elimination. Breathing deeply while doing exercises that involve bending and twisting (or being upside down, as with yoga shoulder- and headstands) can help massage interior organs, promote blood circulation and assist the passage of waste out of the body. Drinking lots of water before, during and after exercise also helps.

I’ve made exercise part of my HIV wellness program for 15 years. My overall goals are to maintain muscle mass, improve the flow of vital energy and help my body with digestion and detoxification. I try to be realistic about my health status, choose exercises carefully and support those choices nutritionally. HIV exercise experts emphasize the importance of choosing exercise that doesn’t create more stress. So I don’t exercise too vigorously, work out where I’m not comfortable or attempt to meet impossibly high standards of physical beauty.

I back off from exercise at signs of stress, such as fatigue that requires more than a day’s recovery. Two summers ago, I biked 30 miles, with no advance training, and spent the next couple of days with runs and fever. Now I do exercises I enjoy, with noncompetitive companions, while breathing deeply and often. I explore practices like yoga, tai chi and qi gong that nurture internal strength and promote the flow of vital energy.

When my weight is stable and I’m feeling good, I incorporate moderate aerobic exercise (walking, jogging, swimming) to stimulate appetite and help with detoxification. Because such exercise further raises the elevated rate at which PWAs burn calories, I increase my food intake. And any time I have an infection, I temporarily eliminate such exercise.

HIV nutritionist Jan Zimmerman says, “Look at exercise as part of a complete energy-balancing program. Make sure your nutritional intake is adequate for your body’s existing needs. Don’t waste scarce resources -- energy and calories -- during times of active infections or when you’re fighting weight loss.” She suggests gentle resistance exercise for such times. During hospital stays I often practiced leg and arm lifts (two sets of 10 -- 12 repetitions, two or three times each day).

Throughout, I ensure that the other half of the equation -- good nutrition -- is present. Since I know that HIV increases my needs, I eat plenty of nutrient-rich organic whole foods that are low in fat, have enough protein and include a wide variety of whole grains, legumes, soy products and seasonal fresh vegetables and fruits. I add small amounts of high-quality animal foods, but avoid processed foods (white flour, white sugar) and additives or preservatives. To keep the calories up, I eat regularly, but not for a half-hour before or after exercising. (The body needs a lot of energy to digest food properly.) And I drink a lot of pure water.

Because nutrient deficiencies are common, I also take supplements. Most HIV nutritionists recommend at least a high-quality multivitamin (with minerals), plus additional vitamins C, E, B-complex and carotenoids (including alpha- and beta-carotene, lycopene and others). These can be critical to a successful exercise program. Deficiencies in vitamins B-1, B-2, B-6, B-12 and C (nutrients that are often missing in people with HIV, according to several studies) can result in muscle weakness, poor coordination and decreased endurance. Carnitine, an amino acid that helps the body use fat for energy, is also often deficient; supplementation may help keep both energy and weight up. (Ask for the prescribed form, Carnitor; it’s covered by insurance and Medicaid.) Vigorous exercise can increase nutrient needs, since key immune-system nutrients including zinc, copper and chromium are lost in sweat.

Before beginning any program of exercise, evaluate your physical and nutritional status with your health care providers. Then check with your local AIDS service organizations for referrals to experts on exercise and nutrition, and put this powerful duo to work for you.